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Organization
INDEPENDENT LIFE LLC
Active
Organization
INDEPENDENT LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PRINCE E. GREEN O.T (AUTHORIZED.REPRESENTATIVE)
(561) 385-0868
Entity
Organization
Contact information
Practice address
4047 OCKEECHOBEE BLVD., STE 123, WEST PALM BEACH, FL 33409-3236
(561) 385-0868
Mailing address
4047 OCKEECHOBEE BLVD., STE 123, WEST PALM BEACH, FL 33409-3236
(561) 385-0868
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
FL
Other
Enumeration date
07/26/2007
Last updated
01/02/2010
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